Dosage forms and composition
Xefocam contains one active component - lornoxicam, which affects the production of prostaglandins. The drug is produced:
- In tablet form: with a dosage of 4–8 mg. Formative components: silicon dioxide, starch, lactose, magnesium stearate. White oblong pills are packaged in paper cellular blisters of 10 pieces. On the surface they have an engraving Lo and a dose designation - the number 4 or 8. The cardboard packaging of the medicine contains from 10 to 50 tablets.
- In the form of a lyophilisate for the preparation of solutions. Yellow dense mass placed in glass bottles - 5 pieces per package. One container contains a medicine in a dose of 8 mg, auxiliary compounds: mannitol, tromethanol.
Mechanism of action
Lornoxicam belongs to the category of non-opioid analgesics. In the body, it inhibits the activity of the enzyme cyclooxygenase, which is responsible for the synthesis of neurotransmitters of pain and inflammation. It also slows down oxidation reactions. The substance does not affect the thermoregulation center, breathing, the functioning of the cardiovascular system, and does not cause drug dependence.
Xefocam in tablets and solution is quickly absorbed into the blood, binding to its proteins. The analgesic effect is observed after 15–20 minutes, reaching its maximum after 1.5–2 hours. Within 3.5–4 hours, the substance is filtered by liver cells and gradually eliminated from the body through the kidneys and intestines. During its activity and elimination, the drug produces almost no metabolites.
If the instructions are followed, Xefocam does not have a pronounced toxic effect on internal organs. Its components do not accumulate in tissues. The product is approved for use by physical parameters in weakened people, with insufficient liver function and excretory system.
Xefocam®
The risk of ulcerogenic effects of the drug can be reduced by the simultaneous administration of proton pump inhibitors and synthetic prostaglandin analogues. If bleeding occurs in the gastrointestinal tract, the drug should be stopped immediately and appropriate emergency measures taken. It is especially necessary to carefully monitor the condition of those patients with gastrointestinal pathology who are receiving a course of treatment with XEFOCAM for the first time.
Like other oxicams, XEFOCAM inhibits platelet aggregation and may therefore increase bleeding time. When using this drug, carefully monitor the condition of patients who require completely normal functioning of the blood coagulation system (for example, patients who are undergoing surgery), have disorders of the blood coagulation system, or are receiving drugs that inhibit coagulation (including low-dose heparin ), in order to promptly detect signs of bleeding.
If signs of liver damage appear (itching, yellowing of the skin, nausea, vomiting, abdominal pain, dark urine, increased levels of liver transaminases), you should stop taking the drug and consult your doctor.
The drug should not be used simultaneously with other NSAIDs.
The drug can change the properties of platelets, but does not replace the preventive effect of acetylsalicylic acid in cardiovascular diseases.
In patients with impaired renal function caused by large blood loss or severe dehydration, XEFOCAM, as an inhibitor of prostaglandin synthesis, can be prescribed only after hypovolemia and the associated risk of decreased renal perfusion have been eliminated. Like other NSAIDs, XEFOCAM can cause an increase in blood urea and creatinine concentrations, as well as water and sodium retention, peripheral edema, hypertension and other early signs of nephropathy. Long-term treatment of such patients with XEFOCAM can lead to the following consequences: glomerulonephritis, papillary necrosis and nephrotic syndrome with transition to acute renal failure. Patients with a pronounced decrease in renal function should not be prescribed XEFOCAM (see “Contraindications”). In elderly patients, as well as in patients suffering from arterial hypertension and/or obesity, it is necessary to control blood pressure levels. It is especially important to monitor renal function in elderly patients, as well as in patients:
- simultaneously receiving diuretics;
- concurrently receiving medications that can cause kidney damage.
With long-term use of the drug XEFOCAM, it is necessary to periodically monitor hematological parameters, as well as renal and liver function.
The use of the drug may adversely affect female fertility and is not recommended for women planning pregnancy.
When is Xefocam indicated: instructions
Among the indications for taking the medication: pain of various origins, subject to the action of non-steroidal analgesics. Including those caused by:
- rheumatoid arthritis;
- deforming arthrosis;
- gout;
- ankylosing spondylitis.
The medication effectively reduces pain to moderate and moderate-to-severe intensity. Xefocam does not affect the general course of diseases; it is used only for symptomatic therapy: in short courses.
The drug is used with caution for pathologies of the gastrointestinal tract, smoking, alcoholism, heart failure, and diabetes.
Contraindications
- combination (complete or incomplete) of polyposis of the paranasal sinuses or nose, bronchial asthma and intolerance to non-steroidal anti-inflammatory drugs (including a history);
- thrombocytopenia;
- bleeding diathesis or bleeding disorders, including conditions after surgical interventions associated with the likelihood of bleeding or insufficient hemostasis;
- the period after undergoing coronary artery bypass surgery ;
- changes in the mucous membranes of the duodenum or stomach of the erosive-ulcerative type, active bleeding from the gastrointestinal tract, as well as cerebrovascular or other bleeding;
- previous bleeding from the digestive organs associated with taking non-steroidal anti-inflammatory drugs;
- recurrent stomach ulcers or repeated bleeding from the digestive system;
- exacerbation of inflammatory bowel disease ( Crohn's disease );
- decompensated heart failure;
- liver failure or active liver disease;
- severe renal failure , progressive kidney disease, hyperkalemia , dehydration or hypovolemia ;
- pregnancy and lactation;
- age less than 18 years;
- allergy to the components of the drug.
Caution should be exercised in prescribing the medicine in the presence of at least one of the following conditions: lesions of the digestive tract of an erosive-ulcerative nature and bleeding of the specified localization, moderate renal failure, conditions after surgery, arterial hypertension , age over 65 years, coronary heart disease , cerebrovascular diseases , chronic cardiac failure, dyslipidemia , peripheral arterial disease, diabetes mellitus , smoking, creatinine clearance up to 60 ml/min, the presence of Helicobacter pylori, ulcerative lesions of the digestive tract in the past, long-term use of anti-inflammatory non-steroidal drugs, severe somatic diseases, alcoholism , joint taking oral forms of glucocorticosteroids, anticoagulants, antiplatelet agents, diuretics, selective serotonin uptake blockers or drugs with nephrotoxic effects.
Concomitant therapy with anti-inflammatory nonsteroidal drugs and Tacrolimus may increase the risk of nephrotoxicity.
The simultaneous use of anti-inflammatory non-steroidal drugs and Heparin against the background of epidural or spinal anesthesia increases the likelihood of epidural and spinal hematomas .
To whom is Xefocam contraindicated?
It is necessary to stop using an analgesic:
- with bronchial asthma complicated by polyposis;
- for erosive and ulcerative lesions of the mucous membranes of the stomach and intestines;
- internal bleeding, suspicion of its presence;
- decreased blood clotting, impaired hematopoietic functions;
- Crohn's disease;
- in the period after heart surgery;
- in case of severe liver dysfunction: cirrhosis, acute hepatosis, hepatitis;
- in case of individual intolerance or allergic reactions to the drug.
Contraindications also include: all stages of pregnancy, children under 18 years of age.
Overdose
In case of an overdose of the drug, the following symptoms are possible: dizziness, nausea and vomiting, ataxia , visual disturbances, convulsions , coma . Changes in the liver and kidneys, as well as blood clotting disorders, are possible.
Treatment of overdose: Stop administering or taking the medication. Lornoxicam is quickly evacuated from the body. Dialysis is ineffective. A selective antidote is not known. In case of poisoning with tablets, emergency measures must be taken, including taking enterosorbents and gastric lavage. Ranitidine or prostaglandin are allowed to be used for the treatment of digestive disorders .
Side effects of the drug
Occasionally, while using Xefocam, nausea, dry mouth, decreased appetite, abdominal cramps, and swelling occur. In isolated cases, it is also possible:
- physical weakness, drowsiness;
- weight loss;
- increased irritability;
- the appearance of stomatitis;
- exacerbation of gastritis.
Overdose increases the risk of internal bleeding and perforation of a stomach ulcer.
Indications for use of the drug Xefocam
for oral administration:
- moderate or severe pain (for example, spinal pain, lumbago/sciatica, pain in the postoperative period, myalgia);
- symptomatic treatment of pain and inflammation in inflammatory and degenerative rheumatic diseases.
For parenteral use:
- pain in the postoperative period and during injury;
- pain syndrome associated with an acute attack of lumbago, ischalgia.
How to use Xefocam
The medication in tablets is prescribed to adults at 4–8 mg per day. The maximum dose per day is 16 mg. The pills should be swallowed without chewing, with 50–100 ml of water. It is important to follow the regimen, taking the medicine orally before meals - 30–40 minutes. Food slows down absorption and reduces the activity of the analgesic in severe pain.
Xefocam injections are given intramuscularly or intravenously. A single dose of the drug is 8 mg. Before administration, the lyophilisate from the bottle is diluted with distilled water in a volume of 2 ml. If necessary, the injection of the drug is repeated after 4–6 hours.
Analogues of Xefocam
Level 4 ATX code matches:
Mirlox
Revmoxicam
Xefocam Rapid
Movalis
Mesipol
Lem
Melbek
Movasin
Piroxicam
Lornoxicam
Arthrozan
Texamen
Amelotex
Meloxicam
- Zornica
- Xefocam Rapid
- Larfix
- Lorakam
- Aroxicam
- Aspikam
- Loxidol
- Melbek
- Meloxicam
- Revmalim
- Rekoksa
The price of Xefocam analogues, which are listed above, is in almost all cases higher than the price of Xefokam itself.
Compatibility of the drug with alcohol and other medications
During the period of use of the medication, alcohol should be avoided, since ethanol greatly enhances its toxic effect. Caution is necessary when using Xefocam simultaneously with Cimetidine, Heparin, Methotrexate, Corticotropin, diuretics, antihypertensive drugs from the group of beta blockers and ACE inhibitors. As a result of their combination, a mutual increase in toxicity is likely.
Xefocam is not recommended to be combined with other non-steroidal analgesics, since all of them are characterized by an anticoagulant effect - a decrease in blood clotting.
During the treatment period, you should also refrain from driving a car or operating complex equipment. Xefocam affects the speed of motor skills and mental reactions, which increases the risk of accidents.
Interaction
When used together with Cimetidine, the concentration of lornoxicam in the blood increases.
When used simultaneously with anticoagulants or platelet aggregation blockers, it is possible that the duration of bleeding may increase and the likelihood of bleeding may increase.
Combined use with Phenprocoumon reduces its therapeutic effectiveness.
When taking anti-inflammatory nonsteroidal drugs along with Heparin during spinal or epidural anesthesia, the risk of spinal and epidural hematomas increases.
When used together with ACE blockers and beta-blockers, their hypotensive effect is reduced.
The drug weakens the hypotensive and diuretic effect of diuretics, and also reduces the clearance of Digoxin .
When used together with other anti-inflammatory non-steroidal drugs or glucocorticosteroids, the risk of bleeding from the digestive organs increases.
When used together with quinoline antibiotics, the risk of seizure syndrome increases.
The drug increases the level of methotrexate in the blood when used together.
When used simultaneously with selective serotonin uptake blockers, the risk of bleeding from the digestive organs increases.
Xefocam can cause an increase in the concentration of lithium in the blood, increasing the side effects of the latter when taken together.
Xefocam stimulates the nephrotoxic effects of Cyclosporine and the hypoglycemic effect of sulfonylurea drugs.
When taken together with potassium supplements, corticotropin , alcohol, the risk of undesirable effects on the digestive system increases.
When used simultaneously with Cefotetan , Cefoperazone , Cefamandole , and valproic acid, the likelihood of bleeding increases.
When taken together with Tacrolimus , the risk of nephrotoxicity increases.
